Spinal arteriovenous malformations: neurological aspects and results of embolization

Abstract

Twenty consecutive patients with spinal arteriovenous malformations (AVMs) were found to have either a progressive, remitting or remitting‐progressive course of disease. A characteristic progressive neurological decline was observed in 11 patients with dural fistulas and a similar decline was seen in 5 of the 9 patients with intradural AVMs. In addition to paraparesis and mixed sensory disorder, which ascended to a level of about T10, areas with spared sensation were occasionally found below this level. All cases with this progressive longitudinal myelopathy showed radiological evidence of a dilated medullary venous plexus. All patients were treated by embolization with only a low frequency of complications. Follow‐up data verified a significant improvement of motor and sensory function, mainly during the first year after embolization. Cases with progressive neurological decline (dural and intradural AVMs) stopped deteriorating or improved and cases with a history of acute incidents (intradural AVMs) probably run less risk of acute deterioration.

Spinal Dural Arteriovenous Fistulas: Clinical Experience with Endovascular Treatment as a Primary Therapeutic Modality

“…Spinal DAVF appears to be particularly amenable to endovascular techniques 5,10,13) . One advantage of endovascular therapy is the ability to diagnose and treat the lesion in a single session; however, more than one session may be necessary for some patients.…”

Endovascular management of spinal arteriovenous malformations

“…The authors conclude that embolization is an option for the treatment of these lesions. Lundqvist and colleagues reported two patients with type B fistulas who underwent PVA embolization 12. Both patients showed clinical improvement but no long-term radiographic follow-up was documented.…”

Extracranial Embolization

“…80,81 8) A study of functional and emotional quality of life in spinal cord AVM patients after embolization showed signi fi cantly worse scores compared to patients with post-traumatic spinal cord problems. 82 This suggests that further improvements in treatment of these patients are necessary.…”